This year, as the Centers for Medicare & Medicaid Services Office of Minority Health (CMS OMH) honors National Hispanic Heritage Month, we hope to focus on prioritizing health for the nation’s 60 million Hispanics by encouraging annual flu shots and sharing resources to help Hispanics take steps toward better health.

Each year from September 15 to October 15, National Hispanic Heritage Month recognizes the contributions, achievements, and histories of Hispanics and Latinos in American culture. Many face unique challenges within the Hispanic community, including language barriers, poverty, lack of education, and immigration status that have affected Hispanics health and health care access.

This year, more than ever, it is important to prioritize our health. Like other minority groups, Hispanics are disproportionately affected by chronic health conditions putting them at an increased risk of developing certain illnesses such as the flu or COVID-19. Factors such as underlying health conditions and a lack of access to health care services put the Hispanic community at an increased risk of contracting these viruses.

As this year’s flu season will be compounded with COVID-19, it is important that all adults and children get the flu vaccine. Although the flu shot can reduce the risk of illness and hospitalization and is covered by Medicare, Medicaid, and most health plans, only 36 percent of Hispanic Medicare fee-for-service beneficiaries and 65 percent of Hispanic Medicare Advantage beneficiaries received the flu vaccine in 2018.

Recognizing Hispanic Heritage Month is part of our strategy to foster innovation by sharing resources and initiatives that can help to improve access to health care services and improve health equity within the Hispanic community. Below are several resources you can use this month and beyond.

Partner Resources

• Review our new data snapshot, Annual Influenza Vaccination Disparities in Fee-for-Service Beneficiaries that provides an overview of the flu vaccine and vaccination rate data by race, ethnicity, and gender among Medicare beneficiaries.
• Read CMS OMH’s, Understanding the Health Needs of Diverse Groups of Hispanic Medicare Beneficiaries, which examines the future medical needs and challenges of a fast growing Hispanic population.
• Review the Racial, Ethnic, and Gender Disparities in Health Care in Medicare Advantage stratified report, which looks at racial and ethnic differences in health care experiences and clinical care for Medicare Advantage beneficiaries.
• View CMS OMH’s Quality Improvement & Interventions to find evidence-based interventions that can contribute to reducing health disparities and lowering cost. Key resources include:
• • A Practical Guide to Implementing the National CLAS Standards
  • Building an Organizational Response to Health Disparities
  • Guide to Developing a Language Access Plan
  • Providing Language Services to Diverse Populations: Lessons from the Field 

• Download and share our Rural Health Strategy: 5 Key Objectives in Spanish and English, which provides five objectives to help move rural health providers and their patients forward.
• Visit the HHS Office of Minority health page for information and social graphics in English, Hispanic Heritage Month page or Spanish, Mes de la Herencia Hispana.

Consumer Resources

• Looking for information on COVID-19? Visit this CMS OMH webpage for COVID-19 Federal resources focusing on vulnerable populations: cms.gov/omhcovid19 and C2C COVID-19: go.cms.gov/c2ccovid19.
• Download and share From Coverage to Care (C2C) resources which are all available in both English and Spanish:
  • A Roadmap to Better Care and a Healthier You
  • A Roadmap to Behavioral Health 
  • How to Maximize Your Health Coverage video series

Share Connected Care resources, such as the “Connecting the Dots” patient animated videos, available in both Spanish and English, to help individuals living with multiple chronic conditions learn more about the benefits of chronic care management services.

The profession of farming began around 12,000 years ago with the domestication of livestock, as hunters and gatherers settled down and started to plan their own food. Farming is one of the oldest jobs around.

Take a moment on October 12 to thank all the farmers that work to grow and produce our food. Remember: their families play a big role too!

 HOW TO CELEBRATE NATIONAL FARMERS DAY

• Thank a farmer for their hard work.
•  Read about a farmer
• Shop at a Farmers Market in Pennsylvania
• Use social media to show gratitude and support: #ThankAFarmer   #NationalFarmersDay   #UndeniablyDairy #
• Plant a garden. Start your own mini-farm.
  • Stores will mark or display locally-grown produce near the front or with signs.
  • Look for PA-Preferred labels on products or marked in the aisles.
  • On milk, if it was bottled in Pennsylvania, the number printed on the outside of the container will begin with #42.

October is Domestic Violence Awareness Month. This month provides an opportunity to remember victims of domestic violence, raise awareness of what domestic violence is, how to recognize it, and what we can all do to collectively prevent it.

Domestic violence is a pattern of coercive behavior used by one person to gain power and control over another in an intimate or familial relationship. In Pennsylvania alone, 112 victims died from domestic violence incidents last year. Domestic violence can happen to anyone regardless of gender, socio-economic status, race, or sexual orientation.

Unfortunately, during this unprecedented time, recommendations necessary to prevent the spread of COVID-19 also lead to those experiencing domestic violence facing even more anxiety and new challenges to navigate. Victims and survivors are spending more time in close proximity with their abusers, increasing the risk to their safety and well-being during an already stressful time. If you or someone you know is unsafe, resources are available.

Help is Available

The Pennsylvania Coalition Against Domestic Violence (PCADV) provides domestic violence services 24-7 via their find help page and the National Domestic Violence Hotline at 1(800) 799-7233 or by texting LOVEIS to 22522. Legal help is available from PCADV at pasafelaw.org.

The Pennsylvania Coalition Against Rape (PCAR) provides sexual assault crisis services. Those resources can be found at www.pcar.org or at 1-888-772-7227 for a 24-hour hotline to be connected to a local sexual assault center. Help for sexual assault survivors is also available from the National Sexual Violence Resource Center (NSVRC).

Suspected child abuse or neglect can be reported 24/7 to DHS’ ChildLine available at 1-800-932-0313.

Healthcare Dive

An influential group that helps shape the nation’s Medicare policy resoundingly advocated for rethinking the program’s advanced alternative payment models, which have largely failed to achieve significant cost savings.

Many members of the Medicare Payment Advisory Commission expressed a desire to condense the sheer number of models during a virtual meeting Friday. The group also expressed an interest at taking a broader look at the program and creating more long-term goals.  One problem is that many of these models have not produced the results stakeholders and policymakers were hoping for, MedPAC staff told commissioners.

Overall, the goal of these payment programs is to either reduce spending without reducing care quality or improve quality without increasing spending.

In evaluating the models over time, MedPAC staff said there were no net savings for Medicare in most models when factoring in performance payments.  Commissioners expressed concern that the models create conflicting incentives, and with the large number, it’s hard to measure what’s working due to any one specific model.  MedPAC Chairman Michael Chernew raised that specific issue in his comments Friday.

“If you’re running 40 models, which is roughly what are being run, and you test all of them supposedly against doing none of the models … the results you get is not just the sum of the results from all of the individual tests because the models interact with each other,” he said. “So, I think, basically CMS has a portfolio problem, and has to come up with a set of models that will work well together.”

Others also supported reducing the number of models. “I’m very much in favor of moving to fewer models. Medicare’s approach to date has been to put a whole lot of shots on goal by implementing lots of different models, Commissioner David Grabowski said. “The idea is that if you take enough shots, something is bound to go in. Unfortunately, as we’ve been discussing, there’s lots of unintended consequences to this approach.”

What was clear from Friday’s discussion is that commissioners are focused on condensing the models and drafting a strategy on how they can fit together. What was less clear was whether those models should be mandatory or voluntary. Members seemed split on this issue, as well as on whether some of those models should be condition-specific.

Others expressed a frustration that the models are built on top of a fee-for-service structure and that some clinicians can continue relying on being paid for volume rather than value.  “We need to send a message that fee-for-service isn’t going to be business as usual,” Commissioner Brian DeBusk said. “We need to create a vision for what fee-for-service is going to look like as the trust fund depletes.”  He suggested, for example, capping all FFS rates in 2027. “Maybe we don’t do updates to fee-for-service rates after a certain date,” DeBusk said.

In prior years, MedPAC has voiced similar concerns and noted the importance of moving away from incentives that reward volume over value. This year, the COVID-19 pandemic has also accelerated some of those worries in the larger industry as providers were forced to stop services. The resulting revenue decline put them in an untenable financial condition.

The Affordable Care Act was an important piece of legislation in teeing up ways to reimburse providers using alternative methods. The ACA also created the Center for Medicare and Medicaid Innovation, which is tasked with testing and creating APMs.

In 2015, the Medicare Access and CHIP Reauthorization Act went further and paved the way for advanced APMs that created 5% bonuses for physicians who participated. As of 2018, 183,000 clinicians participated in one of those models, up from 99,000 the year before.

The “Tracking Invasive Species with Pennsylvania iMapInvasives” newsletter is a triannual newsletter featuring stories written by natural resource professionals and citizen scientists from Pennsylvania who are doing work related to surveying, reporting, and managing invasive plants, animals, and insects in the state. Each story includes a connection to the Pennsylvania iMapInvasives Program, which operates iMapInvasives, an online reporting and data management tool used to track occurrences of invasive species. The goal of the Pennsylvania iMapInvasives Program is to assist natural resource professionals and citizen scientists by advancing their knowledge of species distributions in the state Pennsylvania and to provide a tool which stores both location and management details. Learn more by going to www.paimapinvasives.org. The Pennsylvania iMapInvasives Program is administered by the Pennsylvania Natural Heritage Program.

Click here to read.

The NIOSH Center for Motor Vehicle Safety’s (CMVS) strategic plan for 2020–2029 is now available. The plan identifies research needs for four priority industry sectors and describes how we envision those stakeholders will put research results into practice. The purpose of the strategic plan is to guide NIOSH-funded research to prevent work-related motor vehicle crashes—the leading cause of workplace deaths in the U.S.—and encourage collaboration between the CMVS and external partners.